INDIVIDUAL EDUCATION PROGRAM

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STUDENT NAME: Sarah Douglas SIMS: 2256415

PARENT/GUARDIAN NAME: Tim and Erin Douglas PHONE: 3202554178
ADDRESS: 500 Red River Ave S Richenfield SD 55416 WK PHONE: 3205558811
SCHOOL DISTRICT: Aberdeen SCHOOL: Lincoln Elementary
DOB: December 22 2010 AGE: 7 GRADE: 2nd
GENDER: Female RACE: WH: White

Meeting Date: October 13 2017 Purpose of Meeting

☐ Initial Eligibility, IEP, Placement
Date Services Begin: October 14th 2017
☒ Annual Review of IEP
Annual Review Date: October 13th 2018
☐ Three Year Reevaluation
Date of Eligibility Determination: October 13th 2016 ☐ Dismissal from Services - Date Effective:
☐ Parent Request
Three Year Reevaluation Due By: October 13 2019
☐ Other:

Discussed evaluation results/progress/assessment
method ☒ Yes
TD ED (Parent/Guardian initial)
Copy of evaluation results received ☒ Yes
TD ED (Parent/Guardian initial)
Transition Planning Needed ☒ No ☐ Yes
(*If yes, attach applicable transition pages.)
Student is eligible for special education or special education
and related services as determined by the IEP team
☒ Yes ☐ No
An annual copy of Parent/Guardian Rights was received and
reviewed
October 1st 2017(Date) TD ED (Parent/Guardian Initial)
A copy of the IEP was provided to parent/guardian ☒ Yes
TD ED (Parent/Guardian Initial)

Primary Disability: Specific Learning Disability - 525

IEP Team Membership Signature Date

Parent/Guardian Tim Douglas October 13 2017
Parent/Guardian Erin Douglas October 13 2017
Student Sarah Douglas October 13 2017
School Representative Eric Mann October 13 2017
General Education Teacher Elizabeth Martin October 13 2017
Special Education Teacher or Provider Andrea Overman October 13 2017
Speech/Language Pathologist Olivia Jensen October 13 2017
Individual who can interpret evaluation results Allison Marcus October 13 2017
Other:
Other:
Other:

South Dakota Department of Education Page |1 Revised – July 2014

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Present Levels of Academic Achievement and Functional Performance

In developing each student’s IEP, the IEP Team must consider 1) the strengths of the student; 2) the concerns of the
parents for enhancing the education of their student; 3) the results of the initial or most recent evaluation of the student;
and 4) the academic, developmental, and functional needs of the student.

Provide a statement of the student’s present levels of academic achievement and functional performance, including 1)
how the student’s disability affects the student’s involvement and progress in the general education curriculum (i.e.,
the same curriculum as for nondisabled students); or 2) for preschool students, as appropriate, how the disability affects
the student’s participation in appropriate activities.
Sarah for the most part is a very well-mannered individual who follows directions and interacts with her teachers and
peers appropriately for age level. Sarah also does a very good job at verbalizing stories and they contain characters
and setting along with problem action and a conclusion. When presented with math problems orally Sarah can
compute them along with adding and subtracting numbers up to 20.

Sarah’s parents would like to see Sarah increase her spelling and reading abilities. They have concerns in these
areas currently because they know these areas are only going to get harder as she gets older and they are important
for her future.

Sarah is currently at a 50 word vocabulary when the rest of her peers are at a 150 word vocab level she is at a level
4 Rigby level and is considered preprimer. Her current fluency rate is at 30 words per minute while 2ng graders
should be at a fluency of 80. Sarah can currently spell 26 correct letter sequences and the expectation is 49. Sarah
can spell and complete sentences with inventive spelling and her sentences are logically sequenced. She also can
compute grade level math problems when read to her.

Sarah has very good functional behavior besides for when she struggles with reading. She will throw her books of
her desk and not comply with rules and directions.

Sarah’s lack in reading skills doesn’t allow her to keep up with her peers in the general education classroom. When
she is working on these skills she gets frustrated and doesn’t stay on task.

* Remember to address:
 Strengths & needs using academic achievement (skill based assessment) AND functional performance
 Transition strengths and needs including the student’s preferences and interests (must be in the student’s IEP by age 16)

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Consideration of Special Factors

Is the student limited English proficient? ☐ Yes ☒ No
If the answer to this question is “yes”, please explain the language needs of the student as these needs relate to the
student’s IEP.

Are there any special communication needs? ☐ Yes ☒ No

If the answer to this question is “yes”, please explain the communication needs of the student, and in the case of a
student who is deaf or hard of hearing, consider the student’s language and communication needs, opportunities for direct
communications with peers and professional personnel in the student’s language and communication mode, academic
level, and full range of needs, including opportunities for direct instruction in the student’s language and communication
mode.

Does the student require Braille? ☐ Yes ☒ No

If the answer to this question is “yes”, what instruction in Braille and use of Braille will be provided?

Does the student’s behavior impede his or her learning or that of others? ☐ Yes ☒ No
If yes, what strategies are required to appropriately address this behavior, including positive behavioral interventions and
supports?

Does the student require Assistive Technology Devices and Services? ☐ Yes ☒ No
If yes, what device or service will be provided?

Physical Education: ☒ Regular ☐ Not Required ☐ Adaptive:

Refer to Goals/Goals & Objectives

Hearing Aid Maintenance: ☒ Not Applicable ☐ Yes: Personnel Responsible for Monitoring:
Describe the monitoring process/frequency necessary for maintenance:

Assessment
☒ Student will be taking state and district-wide assessments with or without accommodations.
☐ Student will be taking state and district-wide alternate assessments (The alternate assessment is for students working
in the alternate achievement standards) (Annual goal and short term objectives required)
a. Does the student meet the significant cognitive disability criteria? (If no, student is not eligible to take the
alternate assessment) ☐ Yes ☐ No
b. Explain the reason why the student cannot participate in the regular assessment.

c. Explain the reason why the alternate assessment selected is appropriate for this student.

☐ No state and/or district-wide assessments are required at this student’s grade level during the course of this annual
IEP.

South Dakota Department of Education Page |3 Revised – July 2014

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Educational Goals and Objectives/Benchmarks

Provide a statement of measurable annual goals, including academic and functional goals designed to 1) meet the student’s
needs that result from the disability, 2) enable the student to be involved in and make progress in the general education
curriculum, and 3) meet each of the student’s other educational needs that result from the disability.

Measurable Annual Goal # 1

Given a 2nd grade passage Sarah will increase Proc. Date Prog. Comments:
her vocabulary from 50 words to 100 words. Code/s Code
1

Measurable Annual Goal # 2

When given a 2nd grade list of words to know, 3
Sarah will increase her spelling by knowing 26
words to 50 words with a 90% accuracy. 2

Measurable Annual Goal # 3

When asked to write a 2nd grade level sentence
6
Sarah will write the sentences with correct spelling
with a 95% accuracy 2/3 tries. 2

Measurable Annual Goal #

Procedure Codes (Complete at IEP meeting) Progress Codes Reporting Frequency to Parents
1. Teacher-made tests 6. Work Samples P= Progress being made ☒ Quarterly Reports
2. Observations 7. Portfolios I= Insufficient Progress to meet goal ☐ Trimester Reports ☐ Other:
3. Weekly tests 8. Oral Tests X= Not addressed this Reporting Period Reporting Method to Parents
4. Unit tests 9. Data Response M=Met goal
☒ Conferences ☒ Report Card
5. Student Conferences 10. Other:
☒ Goal Page Copy ☐ Other:

South Dakota Department of Education Page |4 Revised – July 2014

 INDIVIDUAL EDUCATION PROGRAM
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Educational Goals and Objectives/Benchmarks

Provide a statement of measurable annual goals, including academic and functional goals designed to 1) meet the student’s
needs that result from the disability, 2) enable the student to be involved in and make progress in the general education
curriculum, and 3) meet each of the student’s other educational needs that result from the disability.

Measurable Annual Goal #

Proc. Date Prog. Comments:
Code/s Code

Short Term Instructional Objectives or Benchmarks Proc. Date Prog. Comments:

(Required for students who take alternate Code/s Code
assessment.)

Procedure Codes (Complete at IEP meeting) Progress Codes Reporting Frequency to Parents
1. Teacher-made tests 6. Work Samples P= Progress being made ☐ Quarterly Reports
2. Observations 7. Portfolios I= Insufficient Progress to meet goal ☐ Trimester Reports ☐ Other:
3. Weekly tests 8. Oral Tests X= Not addressed this Reporting Period Reporting Method to Parents
4. Unit tests 9. Data Response M=Met goal ☐ Conferences ☐ Report Card
5. Student Conferences 10. Other: ☐ Goal Page Copy ☐ Other:

South Dakota Department of Education Page |5 Revised – July 2014

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Accommodations and Modifications

Accommodations/Modifications/Supplementary Aides and Frequency Location Duration

Services
1. Tests read aloud Daily Sped room. Length of the
2. IEP
3.
4.
5.

Statement of the program modifications or supports for Frequency Location Duration

school personnel (as appropriate):

South Dakota Department of Education Page |6 Revised – July 2014

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State/District-wide Assessment Accommodations

☒ Student will be taking the assessment without accommodations.

☐ Student will be taking the assessment with the accommodations.

*Teams must consider if the accommodations are approved for the applicable test administration.

*List the accommodations the student will be taking for each test/test area.
(Only those accommodations identified for instruction on the goal pages can be considered for state and district-wide
testing. The accommodations selected for use must relate to the student’s disability.)

State Assessment Accommodations

Smarter Balanced Smarter Balanced Dakota STEP

ELA (Gr 3-8 & 11): Math (Gr 3-8 & 11): Science (Gr 5, 8 & 11):
_____________ _____________ _____________
_____________ _____________ _____________
_____________ _____________ _____________
_____________ _____________ _____________
_____________ _____________ _____________

Test: Test: Test:

* NSCS Alt Assessment and D-STEP Alt Science

Accommodations for both instruction and assessment must be documented.

District-wide Assessment Accommodations

Test: Test: Test:

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Special Education Services

Description of services Frequency Location Duration

Reading Instruction Daily 60 Min SPED Room length of the IEP
Spelling Instruction Daily 30 Min SPED Room length of the IEP

Related Service to be Provided Frequency Location Duration

☐ Speech/Language Therapy
☐ Occupational Therapy
☐ Physical Therapy
☐ Transportation (Specify when, how
often, where, distance, costs, etc.)
☐ Counseling Services
(Including rehabilitation counseling)
☐ Audiological Services
☐ Interpreting Services
☐ Medical Services
(Diagnostic Services only)
☐ Orientation and Mobility
☐ Parent Counseling/Training
☐ Psychological Services
☐ Recreation Therapy
☐ School Nurse/Health Services
☐ Social Work Services (in schools)
☐ Other

South Dakota Department of Education Page |8 Revised – July 2014

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Least Restrictive Environment

The IEP Team must ensure that, to the maximum extent appropriate, students with disabilities are educated with
nondisabled peers, including extracurricular services and activities.

Continuum of Alternative Placements Continuum of Alternative Placements (Ages 3-5)

☒ 0100 General Classroom with Modifications 80-100% ☐ 0310 Early Childhood Setting-10 hrs.+/week
services in Reg EC program
☐ 0110 Resource Room 40-79%
☐ 0315 Early Childhood Setting-10 hrs.+/week
☐ 0120 Self-Contained Classroom 0-39%
services in other location
☐ 0130 Separate Day School
☐ 0325 Early Childhood Setting-Less than 10hrs/wk.
☐ 0140 Residential Facility services in Reg EC program
☐ 0150 Home/Hospital ☐ 0330 Early Childhood Setting-Less than 10hrs/wk.
services in other location
☐ 0335 Special Education Class
☐ 0345 Separate School
☐ 0355 Residential Facility
☐ 0365 Home
☐ 0375 Service Provider Location

Participation with Non-Disabled Peers

Program Options Non-Academic Extracurricular
☒ Art ☒ Counseling ☒ Athletics
☒ Math ☒ Clubs
☒ Music ☐ ☒ Groups
☒ Physical Education ☒ Recess ☒ Recreation
☒ Science ☒ Health Services ☐ Other
☐ Other ☐ Other

Comments:

Justification for Placement--An explanation of the extent, if any, to which the student will not participate with
non-disabled students in regular classes and non-academic activities.
(Please use accept/reject format for each alternative placement considered.)
The team determined the appropriate placement to be General Classroom with modifications 80-100%.
The student requires intense reading and spelling instruction in a one-on-one or small group setting which can
be provided in the resource room. The student learns best with direct and quiet instruction with very limited
distractions. The student also strives when given direct feedback which can be provided in a small or one-on-
one setting. Any services pertaining to do with the students learning will be done in the resource room and the
rest of the 80-100% of the day will remain in the general education classroom. Tests will be read aloud in the
resource room.

☒ The team addressed the potential harmful effects of the special education placement.

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Extended School Year

Extended School Year Services: ☐ needed ☒ not needed ☐ to be determined by (Date)

Beginning Date Ending Date Minutes

Goal(s) # *Type of Service **Based on
mm/dd/yy mm/dd/yy Per Week

* Instruction, related services (specify), other (list)

** Regression/Recoupment, Emerging Skills, or Maintenance of Critical Life Skills

South Dakota Department of Education P a g e | 10 Revised – July 2014